Active NPI
Oral Surgery of Central Arkansas
- Oral and Maxillofacial Surgery Clinic/Center
- Conway, AR
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery Clinic/Center
- License
- 3775
- Legal business name
- ORAL SURGERY OF CENTRAL ARKANSAS
- Practice address
- 707 Parkway St Ste 103
Conway, AR 72034-5363 - Phone
- (501) 327-5255
- NPI assigned
- Oct 26, 2015
- Last updated
- Oct 26, 2015
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. John M Johnson, DDS
- Title
- President
- Phone
- (501) 327-5255
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery Clinic/Center | 261QS0112X | 3775 | AR | Primary |
Addresses
Primary practice location
707 Parkway St Ste 103
Conway, AR 72034-5363
Mailing address
707 Parkway St Ste 103
Conway, AR 72034-5363
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 202575679 | Medicaid | AR |
National Provider Directory
National Provider Directory- Tax ID family
- Oral Surgery of Central Arkansas
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Oral and Maxillofacial Surgery Clinic/Center
- North Little Rock, AR
- NPI 1124491733
Locations
707 Parkway St
Ste 103
Conway, AR 72034
Phone (501) 327-5255
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Oral and Maxillofacial Surgery (Dentist)
- Conway, AR
- NPI 1699094714
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1445817600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1445817600000",
"number": "1346612728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "707 PARKWAY ST STE 103",
"city": "CONWAY",
"state": "AR",
"postal_code": "720345363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 PARKWAY ST STE 103",
"city": "CONWAY",
"state": "AR",
"postal_code": "720345363",
"telephone_number": "501-327-5255"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ORAL SURGERY OF CENTRAL ARKANSAS",
"organizational_subpart": "NO",
"enumeration_date": "2015-10-26",
"last_updated": "2015-10-26",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "501-327-5255",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "261QS0112X",
"taxonomy_group": "",
"desc": "Clinic/Center, Oral and Maxillofacial Surgery",
"state": "AR",
"license": "3775",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "202575679",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.